Youth is often the stage of life when people begin to experiment with alcohol and other drugs. While the National Survey of Mental Health and Wellbeing is a cross-sectional survey and causality cannot be determined, young people with a mental disorder* were more likely than those without a mental disorder to have consumed alcohol at least weekly during the previous year, to have misused drugs and to have been current smokers. Mental illness and substance use can occur simultaneously for a number of reasons. The presence of a mental disorder may lead to a Substance Use Disorder as a consequence of self-medication with alcohol or drugs (both legal and illicit), however alcohol and drug misuse can also induce a mental disorder. Alternatively, certain characteristics that are common to both Substance Use Disorders and other mental disorders may increase the likelihood that they will co-occur (5).

DRUGS

Use of illicit drugs, such as amphetamines, and misuse of legal drugs, such as pain-killers, can have harmful effects on individuals. Young people with a mental disorder were more than 5 times as likely as those without mental disorders to have misused drugs in the previous year (36% compared with 7%). Not surprisingly, 55% of young people with a Substance Use disorder reported misusing drugs in the previous year. However, misuse of drugs does not necessarily mean that a person has a drug use disorder. Although 15% of young people reported misusing drugs in the last 12 months, only 3% of young people were diagnosed through the survey instrument as having a drug use disorder in the last year. Around 37% of young people with an Affective disorder and 32% of those with an Anxiety disorder also reported misusing drugs in the previous 12 months (for information on diagnostic criteria, see Chapter 3 of National Survey of Mental Health and Wellbeing: Users' Guide, cat. no. 4327.0).

ALCOHOL

Young people with a mental disorder were over one and a half times more likely than those without a mental disorder to have consumed alcohol at least weekly (57% compared with 34%). Of young people with mental disorders, young men were more likely than young women to drink alcohol at least weekly (73% compared with 44%). Of young people without a mental disorder, 41% of men and 26% of women drank alcohol at least weekly.

Not surprisingly, around 86% of young men and 73% of young women with a Substance Use disorder consumed alcohol at least weekly. However, young people with Anxiety and Affective disorders were also more likely than those without mental disorders to consume alcohol at least weekly. Around 61% of young men with an Anxiety or an Affective disorder consumed alcohol at least weekly, while 47% of young women with an Affective disorder and 36% of young women with Anxiety disorder also consumed alcohol at least weekly (as shown in Graph 2.1).

Graph 2.1 Young people with and without mental disorders(a)(b) by weekly consumption of alcohol, Australia - 2007

(a) People aged 16-24 years who met criteria for diagnosis of a lifetime mental disorder and had symptoms in the 12 months prior to interview.(b) A person may have had more than one disorder. The components when added may therefore not add to the total shown.

Of all young people who consumed alcohol at least weekly in previous year, 24% had an Alcohol Use Disorder (either Harmful Use or Dependency), compared with 6% of those aged 25-85 who had consumed alcohol at least weekly in previous year.

TOBACCO

As well as being physically addictive, tobacco smoking can be a method that people use to deal with feelings such as boredom or stress (6). Young people with a mental disorder were twice as likely as young people without mental disorders to be current smokers (38% compared with 16%). While 51% of young people with a Substance Use disorder were current smokers, around 42% of those with an Affective disorder and 37% of those with an Anxiety disorder were also current smokers.

SOCIAL CONTACT

Interaction with other people is vital to human development. Social relationships and networks can act as protective factors against the onset or recurrence of mental illness and enhance recovery from mental disorders (7).

Throughout adolescence and young adulthood, young people experience a critical period of social and emotional development in their transition from dependence on school and family towards greater independence (3).

In 2007, most young people living in private dwellings had regular contact (defined as contact on 3 or more days a week) with family (87%) and friends (89%), regardless of whether or not they had a mental disorder.

*This article focuses on young people who met criteria for a diagnosis of a lifetime mental disorder and who experienced symptoms in the 12 months prior to the survey.